PENIS - ENLARGEMENT

There has always been a great demand for penile enlargement and dissatisfaction about the length and the girth of the penis in each individual. Many men desire a greater length and the thickness of the penis. It is important for any individual to understand the procedure for the penile enlargement before submitting themselves for these procedures with great expectations.

It is for these men to understand that though these procedures are available and successful but they are meant for "Needy but not for the Greedy".

Surgery is the only means which offers a permanent solution for enlargement of the penis.

There are two types of surgeries involved for the enlargement of penis which involves Lengthening and Widening. These procedures either can be performed separately or together or in a 2 stage procedures whereby lengthening can be followed by widening procedure after 6 to 12 months. Most men are good candidates for penis enlargement surgery to both lengthen and widen the penis.

Penile Lengthening

It is important for one to realize that approximately one-third to one-half of the penis is inside the body, where it is attached to the undersurface of the pubic bone by suspensory ligaments. These ligaments make the penis arch under the pubic bone. Surgically releasing these ligaments brings more of the penis outside the body, allowing it to protrude further outward on a straighter path and providing more functional length. Wearing of penile weights after the surgery are important to maintain penile lengthening.

Releasing the ligament partially frees the penis from its pubic bone
attachments, dropping it to a lower position, which may increase penile
length or give the illusion of length gain. There are various ways of
doing this surgery which may involve YV plasty which may be associated
with deforming hair-bearing hump at the base of the penis. Contrarily
to this a transverse incision is a better approach. One inch gain by this
procedure is considered as success even with use of weights.

BEFORE

AFTER

Penile Widening

There are 2 successful procedures widen the penis and they generally involve grafting procedures - AlloDerm dermal graft and the dermal fat graft techniques. Dermal fat grafts are usually taken from the patient's buttocks or groin and passed under the penile skin. The grafts are obtained from a scar in the donor incision site. Harvesting of the graft adds time to the length of the operation.

AlloDerm dermal grafts are obtained from a tissue bank prior to surgery. This method eliminates incisions and scaring at the donor site, and reduces the duration of the procedure. The grafts can be stacked on top of one another to give the desired width to the penis. Many men obtain a 30 percent permanent increase in penile circumference from this technique.

At the present time, we are not recommending any girth enhancement procedures because the success rate all over the world has limitations.

BEFORE

AFTER

Pentecostal Webbing

The scrotum in some men extends up the underside of the penis, creating
an indistinct junction between the penis and scrotum. This Pentecostal
webbing makes the penis appear short on its undersurface. It can also
cause discomfort with intercourse or difficulty using a condom. The
web may be congenital or due to removal of too much skin from a circumcision.
A mild web is eliminated by rearranging the tissues at the Pentecostal
junction, leaving a zigzag incision (Z-plasty). A more severe web
is eliminated by excision of the web and closure with a linear scar
and Z-plasty. Simple web excision by leaving a linear scar may result
in tightening and worsening of the web. This procedure is relatively
simple

BEFORE

AFTER

Obesity

Some men may achieve length gains up to two inches in the flaccid state, but the average gain is approximately an inch. With erection, there is usually a slightly smaller length increase. If a large pubic fat pad is present, some penile length may be obtained by significant weight loss (greater than 35 pounds) or by liposuction or surgical excision.

Penis enlargement surgery is permanent; however, some patients develop scar tissue, which somewhat reduces the length. Injections, medication or topical agents often can remedy the situation. Men who desire additional widening may choose to repeat the procedure.

Commonly asked Questions:-

Q: WHO IS A CANDIDATE FOR THIS SURGERY?
A: Penile surgery is elective and best performed on healthy realistic patients. It is meant for "Needy and not Greedy".

Q: DOES SURGERY AFFECT PENIS SENSATION?
A: Transitory changes in feeling due to swelling and bruising are normal after any surgery. Permanent loss of feeling would be a rare complication.

Q: WILL PENIS FUNCTION BE AFFECTED?
A: Function (urination and copulation) should not be affected. But, the angle of the erection will change slightly from more vertical to more horizontal.

Q: HOW LONG DOES THE SURGERY TAKE?
A: The procedure takes a couple of hours and the patient remains for observation for at least 24 hours prior to discharge.

Q: WHEN CAN YOU RETURN TO WORK?
A: Light duties may be resumed in a week but it is best to take at least two weeks off work, especially if it is strenuous.

Q: WHEN CAN SEXUAL ACTIVITIES BE RESUMED?
A: It is recommended that the patient refrain from sexual activities for at least 4 weeks. Medication to reduce nocturnal stimulation is given for 10 days post-op.

Q: WHAT IS TO BE EXPECTED DURING THE HEALING PHASE?
A: The penis and scrotum are usually swollen and bruised for two to three weeks. Pain is not severe. Soreness in the groin and pubic regions which lasts for about ten days is controlled with light oral analgesics. The scar in the pubic hair area may take many months to fade and soften but it is hidden and not usually a concern.

Q: HOW MUCH CAN THE PENIS BE LENGTHENED?
A: The amount varies with each individual. At present, there is no test to determine the amount pre-operatively. From 1/2 to 2 inches is a reasonable estimate. Therefore men who are larger than average should carefully consider the risks before undergoing surgery. Also, the use of weights (or other means of traction) attached to the penis after surgery not only maintains the new length, but also may add further length.

Q: CAN LENGTH AND GIRTH PROCEDURES BE PERFORMED AT THE SAME TIME?
A: No. Patients should wait for 6-12 months after lengthening before fat injection or dermal-fat grafting is performed. Injected fat cells are mobile and fragile. They would be adversely affected by the post-op penis lengthening protocol.

Q: WHAT IS THE FOLLOW-UP AFTER SURGERY?
A: Patients are seen the next day. Their dressings are changed and instructions are given with respect to bathing and other activities. It is recommended that patients wear loose clothing on the day of surgery and for the early healing period. The next visit is two to three days later at which time most patients are able to start their own wound care, shaft wrapping and commence regular bathing. Sutures are removed 7-10 days post-op. Lead weights or other forms of traction are started a few weeks after the stitches are out and the incisions are firmly sealed (Smokers beware!). Some patients maintain traction for up to 6 months after surgery. This reduces the chance of retraction, stretches shaft skin and in some cases results in further lengthening by stretching tissues which could not be cut at surgery.

Q: HOW CAN OUT OF TOWN PATIENTS BE TREATED?
A: You should forward a complete history and medical reports. It is mandatory for patient to be examined, evaluated and discuss various options with Dr. Dilip Raja. It may be possible to coordinate everything with only one extended trip to Mumbai, India. We also recommend that patients stay in Mumbai for at least one week after surgery. All patients must have a companion (friend, spouse or nurse) with them for the night after surgery. Post-op convalescence can be arranged at an extra cost